Provider Demographics
NPI:1093997025
Name:MIGUEL, KAREN FELICIANO (PT)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:FELICIANO
Last Name:MIGUEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15518 PONDEROSA BEND DR
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-7346
Mailing Address - Country:US
Mailing Address - Phone:800-854-4589
Mailing Address - Fax:205-520-0455
Practice Address - Street 1:15518 PONDEROSA BEND DR
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-7346
Practice Address - Country:US
Practice Address - Phone:800-854-4589
Practice Address - Fax:205-520-0455
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-30
Last Update Date:2018-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070016070225100000X
TX1235429225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist